Cerebral blood flow and cognitive function in HI-infected men with sustained suppressed viremia on combination antiretroviral therapy
Cerebral blood flow and cognitive function in HI-infected men with sustained suppressed viremia on combination antiretroviral therapy
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DOI：
10.1097/qad.0000000000001414
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发表时间：
2017-03-27
期刊：
影响因子：
3.8
通讯作者：
Majoie, Charles B.
中科院分区：
文献类型：
--
作者：
Su, Tanja;Mutsaerts, Henri J. M. M.;Majoie, Charles B.
目的：评估长期成功联合抗逆转录病毒治疗的HIV感染患者与HIV未感染者相比是否显示脑血流（CBF）改变，否则类似的对照。为了探讨这种改变是否与艾滋病毒相关的认知功能障碍，并探讨潜在的决定因素CBF改变在HIV.Design：横断面比较CBF在一个观察性队列study.Methods：临床，认知和MRI数据的100名中年aviremic HIV感染的男性联合抗逆转录病毒治疗和69 HIV未感染的对照进行了收集和比较。根据伪连续动脉自旋标记MRI数据，计算CBF图。平均灰质CBF与临床和认知参数的协会进行了探讨回归models，随后由空间划定在一个基于体素的analysis.Results：CBF减少HIV感染患者与HIV未感染的对照组（P = 0.02），调整年龄，摇头丸的使用和腰围。脑灰质总体积和HIV血清状态对CBF.Within HIV感染组，CBF下降与甘油三酯水平升高（P = 0.005）和既往临床AIDS（P = 0.03）相关。CBF和认知功能障碍之间没有关联被发现。结论：减少CBF中观察到HIV感染者，这是与血管的危险因素，以及与过去的免疫缺陷的措施。这些结果为以血流动力学改变为代表的HIV感染患者血管疾病增加提供了支持，但在目前长期成功治疗的患者队列中没有明显的认知后果。版权所有（C）2017威科医疗集团All rights reserved.
Objective: To assess if HIV-infected patients on long-term successful combination antiretroviral therapy show cerebral blood flow (CBF) alterations in comparison with HIV-uninfected, otherwise similar controls. To explore whether such alterations are associated with HIV-associated cognitive impairment and to explore potential determinants of CBF alterations in HIV.Design: Cross-sectional comparison of CBF in an observational cohort study.Methods: Clinical, cognitive and MRI data of 100 middle-aged aviremic HIV-infected men on combination antiretroviral therapy and 69 HIV-uninfected controls were collected and compared. From pseudocontinuous arterial spin labeling MRI data, CBF-maps were calculated. The associations of mean gray matter CBF with clinical and cognitive parameters were explored in regression models, followed by a spatial delineation in a voxel-based analysis.Results: CBF was decreased in HIV-infected patients compared with HIV-uninfected controls (P = 0.02), adjusted for age, ecstasy use and waist circumference. Spatially distinct and independent effects of total gray matter volume and HIV-serostatus on CBF were found. Within the HIV-infected group, decreased CBF was associated with increased triglyceride levels (P = 0.005) and prior clinical AIDS (P = 0.03). No association between CBF and cognitive impairment was found.Conclusion: Decreased CBF was observed among HIV-infected patients, which was associated with both vascular risk factors as well as with measures of past immune deficiency. These results provide support for increased vascular disease in HIV-infected patients as represented by hemodynamic alteration, but without overt cognitive consequences within the current cohort of patients on long-term successful treatment. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.